Purpose or Case Report: In a Radiology Department that solely cares for pediatric patients, transitioning from computed radiography (CR) to digital radiography (DR) was a challenge. The software for the DR system is designed for imaging adults and has limited pediatric processing features. In the CR system, technologists would manually adjust the imaging technique to child appropriate values based on a technique chart and the usage of a vast array of processing tools. With DR, these charts and processing tools became obsolete. In addition, for the DR wireless flat panel detector to process the image correctly, four percent of the surface area must be exposed to radiation; a challenge in pediatric imaging. Therefore in order to achieve significant reduction in radiation exposure with DR equipment, extensive staff education, algorithm and technique chart modification is required.
Methods & Materials: A pedaitric radiology interdisciplinary team was established, including radiologic technologists, radiologists, quality analysts, an educator, the DR vendor application specialist, and the organization’s Radiation Safety Officer. The team utilized resources from Image Gently, the ASRT s White Paper Best Practices in Digital Radiography, and the American Association of Physicists in Medicine’s Report of Task Group 116, as well as, vendor recommendations to provide education, formulate custom algorithms designed to compensate for limited image processing tools, adjust for lack of surface area exposure and transition the obsolete technique chart into a useful standardized version. Efforts were made for establishing a process to analyze images being repeated by technologists and for creating a method giving radiologists the ability to provide feedback on images through a modification to our coding system.
Results: The implementation of a standardized technique chart for DR utilized in a pediatric setting resulted in a reduction of radiation exposure and the development of custom algorithms. The custom technique chart, shown to be effective, is being utilized by the equipment vendor as a resource and educational tool during new equipment installations. Effectiveness is continuously monitored for trends through the established educational code and repeat analysis by the interdisciplinary team.
Conclusions: Having optimized image quality and successfully reduced radiation exposure, which directly effects patient safety, Children’s Healthcare of Atlanta Radiology Departments will continue to utilize standardized best practices for DR.